Home Care Strategy Lab

#82 You might be spending money on technology that isn't solving a real problem. Dave Dworschak from Phoebe is back to discuss owners buying technology out of FOMO, implementing tools without staff buy-in, over-automating client interactions, and failing to understand whether their teams actually need additional capacity. Drawing on experience with 800+ home care agencies, Dave breaks down where automation is delivering measurable results, where human involvement is still essential, and why the last 20% of building a reliable solution is often the hardest. We also discuss whether early adopters are gaining a competitive advantage, how to build internal AI champions, and what questions you should be asking vendors before signing a contract.

• Dave Dworschak on LinkedIn
• Email: dave@phoebe.work
• Phoebe website / phoebe.work
• Ep #45 with Dave—AI scheduling deep dive
• Ep #64 with Phoebe customer: Nate West

#81 The first two years of home care ownership are brutal, and Adam and Marlene Bartlett aren't sugarcoating what it took to build Uplift Home Care from scratch. After investing $200–250K to launch their independent agency in California, they quickly discovered that finding clients was harder than recruiting caregivers, client churn was twice what they'd projected, and building meaningful referral relationships took far longer than expected. They share what's worked (and what hasn't) across caregiver recruiting, paid advertising, community marketing, and early office hires—including why promoting a caregiver into a care coordinator role became one of their best decisions. They've also built an unusually lean operation, using an offshore scheduler and AI to handle roughly 90% of their caregiver hiring process and 70% of their client intake and care planning workflow.

• Adam Bartlett
• Marlene Bartlett
• Uplift Home Care

Sponsors:

• Reel Home Care Consulting—meet Becky Reel and her team
• Greeley—mention the LAB for a discount on your first 3 months

#80 After nearly 15 years of serving thousands of veterans, Megan Casey has learned that one of the hardest parts of veteran care is getting fiercely independent veterans to accept help in the first place. She explains why agencies need to work around a veteran’s pride rather than try to change it, and why the best approach is simply meeting them where they are. Megan shares stories of veterans who started with just an hour or two of care before building enough trust to accept more help as their needs changed. She also gets candid about PTSD, addiction, isolation, weapons in the home, and the difficult balance between respecting a veteran’s choices and protecting caregivers. Most importantly, Megan explains why that first caregiver match matters so much—and why agencies should put down the assessment form, learn what makes the veteran tick, and earn their trust before trying to change their routine.

• Megan Casey on LinkedIn
• Email: meganc@momentumhtconsulting.com
• Cell: 315-794-6501
• Momentum Healthcare and Technology Consulting

Sponsors:

• Greeley Capital / http://www.greeleycapital.com/thelab
• Mention the LAB and get discounted financing for the first 3 months

#79 Does this sound like your agency?

• You have several key office employees.
• Everyone is busy, but work still gets stuck.
• Leaders are wearing multiple hats.
• Bottlenecks are slowing growth.
• The business is beginning to plateau.

You know your agency needs to be redesigned so your best people can spend more time doing their highest-value work—but you don’t have the time or a clear model for doing it.

This session will help you identify structural bottlenecks, clarify roles and ownership, and redesign your team to support the agency’s next stage of growth.

• Debbie Miller on LinkedIn
• Download the Optimize Workbook
• Optimize Session Slide Deck
• Learn more about Helper Heroes VAs for home care
• Book a 1-1 with Helper Heroes team

#78 Does this sound like your agency?

• You’re still doing almost everything yourself.
• You have one or two office employees.
• Your processes are still evolving.
• Every new hire feels expensive.
• Growth still depends heavily on you, the owner.

You know you need more help—but you also need to make the right hires, assign the right responsibilities, and build the right infrastructure before you and your team burn out.

This session will help you understand what your agency needs now, what can wait, and how to build an office team that supports your next stage of growth.

• Debbie Miller on LinkedIn
• Download the Build Workbook
• Learn more about Helper Heroes VAs for home care
• Book a 1-1 with Helper Heroes team

#77 Most Medicaid billing problems begin long before a claim is submitted, with breakdowns in eligibility, authorization, scheduling, EVV, documentation, payer setup, or coding. Julio Barea, founder of the Home Care Revenue Institute, explains why agencies need to think beyond billing and manage the entire revenue cycle from intake through payment. He walks through the controls behind a clean claim, including how to verify authorized hours, reduce EVV exceptions, and catch problems before they become denials. Julio also shares the daily, weekly, and monthly cadence agencies should follow, along with critical KPIs like denial rate, payment time, EVV acceptance, and scheduled versus authorized hours. He closes with practical ways agency owners can better support their billers and develop them into trained revenue cycle management specialists.

• Julio Barea on LinkedIn
• Email: Julio@mycareoperator.com
• Home Care Revenue Institute
• Home Care Revenue Specialist Certifications
• Slide Deck that goes along with the episode

Sponsors:

• Reel Home Care Consulting / reelhomecareconsulting.com

#76 - More revenue doesn’t automatically solve cash flow—especially when payroll is weekly and payers can take 30, 60, or even 90 days to reimburse. Domenic Colavito, co-founder and COO of the $15 million OurCare Health, breaks down lines of credit, payroll funding, factoring, asset-based lending, SBA loans, and equity financing. He explains how an agency’s size, payer mix, profitability, collection time, and growth goals determine which options are actually available—and which are worth the cost. Domenic also explains factoring in simple terms and shares how predictable cash flow helped OurCare grow from roughly $6 million to $10 million without giving up equity or worrying about weekly payroll. The conversation covers the risks of financing, the billing problems it can expose, and what owners should clean up before approaching a financial partner.

• Domenic Colavito on LinkedIn
• dcolavito@greeleycapital.com
• Greeley Capital / http://www.greeleycapital.com/thelab
• Mention the LAB and get discounted financing for the first 3 months

Sponsors:

• Helper Heroes / https://helperheroes.com

#75 Keyur Shah entered home care with no ownership or healthcare experience and grew Senior Helpers of Coastal Orange County to 1,000 weekly hours in just 20 months. He walks through the agency’s growth month by month—from reaching 300 hours in Month 3 and becoming profitable in Month 9 to generating $700,000 in Year 1. Keyur explains why he opened with an office manager, added a VA recruiter in Month 4, hired a full-time scheduler near 500 hours, and waited until Month 18 to hand off client care. He also shares the ~$150,000 investment it took to reach operational breakeven, the impact of sudden client losses, and why consistent referrals took more than two years of networking. His biggest lesson applies to owners at every stage: don’t wait to grow before you hire—hire the team that can create and sustain the growth.

• Keyur Shah on LinkedIn
• Email: Kshah@seniorhelpers.com
• Senior Helpers of Coastal Orange County

Sponsors:

• Vitable
• Reel Home Care Consulting

#74 Tribute Home Care has no engineers, so Andrew Dobson stepped up and is helping build AI tools in-house that collectively save 300+ hours per month. He explains how a scheduling dashboard evolved into an availability analyzer that helps staff new cases faster at 90–95% caregiver utilization. Tribute also used a Viv-built voice agent to fill 75% of its open weekend visits in an early test. Andrew shares how they condensed a five-system lead process into one workflow and reduced two days of financial reporting to a button press. He offers practical advice for finding the right AI projects, developing an internal champion, validating outputs, and keeping humans involved wherever judgment and relationships matter.

• Andrew Dobson on LinkedIn
• Andrew.Dobson@tributehomecare.com
• Tribute Home Care
• Claude Code

Sponsors:

• Phoebe—AI scheduling teammate that fills 75% of shifts in under 15 minutes
• Reel Home Care Consulting—my recommended consultant for startups focused on differentiation and delivering a hospitality-like experience

#73 After six home care companies merged, Caregivers of America was left with six ways of doing things, costly process gaps, and no clear ownership of the full client journey. Regional Administrator Jenni Scherer explains how the company rebuilt operations around five stages of the client journey: FirstTake, InTake, UpTake, CareTake, and ReTake. She breaks down the touch-points behind the model, including an in-home visit that converts close to 99% of prospects, five coordinator calls during the first 30 days, and regular in-person visits for VIP clients receiving 30 or more hours of care each week. Jenni also shares why the journey shouldn’t end at discharge: returning former clients have become Caregivers of America’s second-largest referral source, followed by referrals from clients’ families and friends.

• Jenni Scherer’s email: Jenni@caregiversofamerica.com
• Caregivers of America
• Take5 Model ’T’ Chart

Sponsors:

• Reel Home Care Consulting // https://reelhomecareconsulting.com

#72 Saying yes to every family might increase revenue, but one wrong-fit client can cost your agency caregivers, reputation, and weeks of scheduling headaches. Becky Reel explains the waitlist mindset she used to protect her team, strengthen the client experience, and create demand—and why a true waitlist is fundamentally different from a staffing problem. She shares the hard lines her agency established around shift minimums, geography, caregiver safety, unrealistic expectations, and families who began negotiating from the first conversation. We also break down what a hospitality-driven intake call sounds like and why every office employee should be prepared to handle one. Becky closes with four super powerful mindset shifts that will help your agency become easier to refer, more memorable, and impossible to confuse with the competition.

• Becky Reel on LinkedIn
• becky@reelhomecareconsulting.com
• Reel Home Care Consulting
• Becky’s Dinner Series

Sponsors:

• Vitable Health - https://learn.vitablehealth.com/lab

#71 Total Care Connections CEO Daniel Stringer shares how his team supports a workforce of roughly 1,000 active employees delivering 17,000 hours of care each week. He breaks down a paid-leave program that provides six weeks after childbirth plus two weeks of parental leave for birth, foster, and adoptive parents. He explains the company’s employee relief fund and how it has awarded 264 grants totaling more than $200,000, with employees eligible for up to $1,000 annually. Daniel also shares how moving to self-funded health insurance helped the company keep employee costs flat despite receiving a 76% renewal increase—and reduced some employees’ prescription costs from $500–$700 per month to $50 or even zero. This episode gives home care owners three tangible ways to invest in caregivers and start building benefits that meet our workforce needs.

Connect with Daniel

• Daniel Stringer on LinkedIn
• Daniel’s email: DStringer@totalcareconnections.com
• Total Care Connections

Employee Relief Fund

• Total Care Connections Grant Circle powered by Canary
• Canary—emergency relief fund solution to aide your team members in times of crisis

Self-Insured Health Care Partners

• To set up Self Insured Health Plan Options: https://www.thegibsonedge.com/services/employee-benefits

Vendors they use in the health plan:

• SHARX: https://sharxplan.com/
• Auxient: https://www.auxiant.com/
• Pareto: https://paretohealth.com/
• Procedures/Imaging: https://www.valenzhealth.com/
• Pharmacy Benefits Manager: https://truerx.com/

Sponsors:

• Vitable Health
• Helper Heroes—mention the LAB

#70 A typical $4-5M home care agency usually has the team, infrastructure, and capital to consider their next growth move—opening a new office, adding a new payer contract, or investing in a strategic leader. Adam Shriver, Client CFO at The Home Care CPAs works with dozens of agencies to evaluate revenue, profitability, and operational stability going into making these large growth decisions. He walks through the evaluation he conducts, the questions he asks, gross margin vs operating margin, and the other factors agencies should consider before going down a specific growth path—if you’re considering a new office or new payer contract, this episode is highly relevant.

• Adam Shriver on LinkedIn
• Adam’s email: ashriver@thehomecarecpas.com
• The Home Care CPAs
• Margin Matters—a home care-specific online financial community for owners or finance roles (free until the end of ’26)

Sponsors:

• Phoebe—best AI scheduling agent for home care
• Vitable Health—health plans for home care that your team will actually use

#69 Most home care agencies are drowning in reports but still struggling to identify problems before they impact growth. Krystal Wilkinson, President of Adultcare Assistance Home Care, shares the 18 core KPIs she and her leadership team review every week across recruiting, scheduling, care management, sales, and HR & finance—and explains why leading indicators matter far more than monthly reports. You'll learn why her agency targets a 25–27 hour average client census, aims to hire caregivers in under 7 days (currently averaging 9 days), tracks 25 meaningful referral visits per week, and uses data to predict staffing needs, revenue dips, and referral trends before they happen. Krystal also explains how her team uses AI-powered dashboards, why every department owns specific numbers, and how they've refined their scorecard over 15 years of trial and error.

• Krystal Wilkinson / KDW@adultcareassistance.com
• Adultcare Assistance

Sponsors:

• Vitable Health - learn.vitablehealth.com/lab

#68 When a caregiver asks, “when do I get my next raise?”, do you have a good answer? Kimberly Jones, Vice President of Help at Home Senior Care, shares the transparent four-part compensation framework her team uses to reward skill development, specialized training, long-term commitment, and leadership. We break down hands-on competency evaluations, dementia skill assessments, certification pathways, longevity bonuses, and why clear career progression has helped the agency retain caregivers for many years. Kimberly also shares the retention data behind the program, including why 66% of their caregivers have stayed for more than two years and why their highest-paid caregivers average 6.5 years with the company.

• Kimberly Jones
• Help at Home Senior Care
• Grade Us—feedback loop tool

Sponsor:

• Vitable Health - learn.vitablehealth.com/lab

#67 Ryan Whittington, CEO of Seniors Home Care in St. Louis, shares how one struggling dementia client led his team to build Sage In-home Memory Care—a completely separate brand dedicated to serving advanced dementia clients with a fundamentally different care model. Instead of treating dementia as another service line, Ryan explains how specialized caregivers, weekly care management visits, life story assessments, individualized activity calendars, and intensive training have created better outcomes for clients, families, and caregivers alike. We also discuss why consistency matters more than flexibility, how to overcome resistance to care, why advanced dementia clients require a true team approach, and the business decisions that make this model sustainable.

• Ryan Whittington
• Seniors Home Care
• Sage In-home Memory Care
• Life Story Assessment - provided by Sage
• Best Practices Booklet--Dementia Home Care (Alzheimer’s Association)
• Teepa Snow’s 6 GEMS You Need to Know For A Positive Approach to Dementia Care

#66 Adam Berry built As Close as Family over nearly a decade before realizing the business had outgrown what he could sustainably manage on his own. Rather than walking away, he sold the agency to Avenues Home Care and stayed on to focus on the work he enjoys most while gaining the back-office support he was missing. In this episode, Adam and Avenues CEO Doug Markham break down how they found the right acquisition fit, what due diligence actually looked like, and why culture mattered more than valuation. They also share how they divide responsibilities after the sale, which functions are centralized versus kept local, and why giving operators autonomy has been critical to continued growth.

• Adam Berry / adam@ascloseasfamily.com
• As Close as Family
• Doug Markham / doug.markham@avenueshomecare.com
• Avenues Home Care

Sponsors:

• https://www.phoebe.work/ - A self-driving alternative that fills shifts in minutes

#65 Many home care agencies don't realize they've crossed the Affordable Care Act threshold until the IRS comes knocking. Brendan Mullins, CRO of Vitable Health, explains why agencies with as early as $1–2M in annual revenue can already qualify as Applicable Large Employers, how 30 hours per week (not 40) triggers eligibility, and why variable caregiver schedules make ACA compliance especially difficult. We break down how the 50 Full-Time Equivalent (FTE) threshold is calculated, the misconceptions that lead agencies into trouble, and why penalties can quickly climb into the six figures. Brendan also walks through how ACA audits typically unfold, why compliance issues often surface years later, and the common mistakes agencies make along the way.

• Brendan Mullins on LinkedIn
• Vitablehealth.com
• ACA Penalty Calculator

We cover:

• Why home care leaders are moving from AI exploration to real-world adoption.
• The buy-vs-build debate and why many agencies are choosing AI partnerships.
• Helping schedulers spend less time chasing call-outs and more time supporting people.
• Supporting owner-operators as they scale from zero schedulers to their first hire.
• How AI can fill open shifts in minutes instead of hours.
• Moving from reactive scheduling to planning weeks in advance.
• Capturing caregiver preferences and scheduling knowledge through AI memory.
• Preventing tribal knowledge from walking out the door with staff turnover.
• Why AI works best as an amplifier—not a replacement—for great schedulers.
• Lessons learned from overcoming office-team skepticism and driving adoption.
• The surprising ways caregivers are embracing AI-powered communication.
• How AI is creating more proactive and human-centered operations.

Extras:

• Connect with Corey Grissom / corey@phoebe.work
• See how Phoebe can transform your scheduler’s daily life

We cover:

• Brady's journey from audiology to home care innovation.
• Right at Home's growth to 600+ franchises across four countries.
• Staying focused on non-medical home care.
• Why AI is exposing long-standing data quality issues.
• The importance of data hygiene and integrity.
• How bad data can erode trust and create risk.
• Common gaps in referral tracking, scheduling, and workflows.
• Making care documentation easier through voice-to-text technology.
• Aligning caregiver incentives with better documentation.
• Combining in-home observations with vital sign data.
• Moving from documentation to predictive care.
• Piloting RespirAIto identify COPD exacerbations earlier.
• Using technology to reduce avoidable hospitalizations.
• Why strong documentation is the foundation for predictive analytics.
• Solving for affordability, workforce shortages, and chronic disease.
• How home care can become the preferred model for aging in place.
• Navigating the realities of aging while embracing innovation.

Some extras:

• Connect with Brady Schwab / bschwab@rightathome.net
• Learn more about Right at Home
• RespirAI—the COPD pilot that Right at Home is conducting
• See how Phoebe AI can eliminate missed clock in/outs and save your team hours each week